Abstract 10059: In-Hospital Outcomes of Percutaneous Coronary Intervention versus Coronary Artery Bypass Surgery in Patients with STEMI Due to Unprotected Left Main Disease- A National Propensity Matched Analysis

Abstract

Introduction: Comparative outcomes for percutaneous coronary intervention versus CABG surgery for left main coronary artery disease remains limited from a large national database. Methods: We studied comparative outcomes of PCI versus CABG using the US national inpatient sample database from 2015 to 2018 for left main disease presenting as STEMI. Results: A total of 930 and 535 patients with STEMI underwent PCI and CABG respectively. The patients undergoing PCI were older (67.5 years [Interquartile range (IQR),59-77]vs 67 [59-74]). Adjusted mortality was much higher in CABG (18.80%) as compared to PCI (7.6%). Higher percentage of patients were discharged to home after PCI as compared to CABG (49.70% vs 27.60%). Conversely, as compared to PCI a higher number of patients undergoing CABG were discharged to long-term care facility (71.90% VS 50.20%). Cost of care ($ 48703[IQR, 36803-71262] vs $ 30376 [19161-52207]) was considerably higher with CABG. The odds of in-hospital mortality and adverse events for CABG compared to PCI are depicted in figure 1. Conclusions: PCI may be associated with lower in-hospital mortality and adverse events when compared to CABG for unprotected left main disease.